NCG080720_MONITORING INFO_20141230

m-W
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
1V C� -7a �
DOC TYPE
El HISTORICAL FILE
L�} MONITORING REPORTS
DOC DATE
❑ � (N � o� � D
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCGO80000
CERTIFICATE OF COVERAGE NO. NCG0807,aZO _
FACILITYNAMF. yIrA
PERSON COLLECTING SAMPLES 1 la
CERTIFIED LABORATORY - 4,jAhcal.' AJC, Lab #�40v
�76 twzrj,ab # O!Y
SAMPLES COLLECTED DURING CALENDAR YEAR:��
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY 1
PHONE NO. (%br 39 3�21 f
PLEASE SIGN ON THE REVERSE -->
Part A: Vehicle Maintenance Areas Monitoring Requirements
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _'eyes —no
(if yes, report your analytical results in the table immediately below)
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00530
00400
00556
Total Suspended Solids,
m
pH,
Standard units
Oil and Grease,
m
New Motor Oil Usage,
Annual averse gallmo
Benchmark
-
100
Within 6.0 - 9.0
30
-
CO
-1 •
7,,24
AIP
250
y
1
f.SDiL
7,/f
N
zS o
UD3
1
fs0 PAAI-
7.5
10
1 2-5o
Note: If you report a sampled value in excess of the bench`tf►ark value. or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text. A$) 7 79 Ar,0 215-0
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
ME
pH,
Standard units
Permit Limit
-
30
100
6.0 - 9.0
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
ReCEIVED
IEC 3 0 2014
CENTRAL FILES
OWR SECTION
Mail Original and one copy to:
Division of Water Quality
Attw DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S W U-250-102107
Page 1 of 2

"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief,
true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations."
d,- /z Zf ?,/-f
(Signs ure of
e ttee) (Date)
S W U-250-102107
Page 2 of 2

t\_
WISM
ATORIES, ING
Full -Service Analytical &
Environmental Solutions
Lane Construction Corporation, The
Marcus Hackler
8205 Wilkinson Blvd.
Charlotte, NC 28214
NC Certification No. 402
SC Certification No. 99012
NC Drinking Water Cert No. 37735
VA Certification No. 460211
Do0 ELAP: L-A-B Accredited Certificate No. L2307
ISOIIEC 17025: L-A-B Accredited Certificate No. L2307
Project: Wilkinson Blvd, Shop
Lab Submittal Date: 05/1512014
Prism Work Order: 4050398
Case Narrative
05/30/2014
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
i - � 0,
Ifawt I
Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
Reviewed By Terri W. Cole
Project Manager
OG HEM O&G is less than the reporting limit, therefore TPH (SGT-HEM) is less than the reporting limit. Sample not
extracted for TPH (SGT-HEM).
BRL Below Reporting Limit
MOL Method Detection Limit
RPD Relative Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MOIL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Sp►ingbrook Road - P.O. Box 240643 - Charlotte, NC 28224.0643
Phone: [phone] - Toll Free Number: 1-800152"364 - Fax: [phone] Page i of 7

PRISM
= Full-Sarvice Analytical $
P R I M I Environmental Solutions
©7i..noR+rowie� �»c
Sample Receipt Summary
05/30/2014
Prism Work Order: 4050398
Client Sample ID Lab Sample ID Matrix Date Sampled Date Received
Outfall #1
4050398-01
Water
05/15/14
05/15/14
Outfall #2
4050398-02
Water
05/15/14
05/15/14
Outfall #3
4050398-03
Water
05/15/14
05/15/14
Outfall #4
4050398-04
Water
05/15/14
05/15/14
Samples were received in good condition at 1.6 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.D. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone]
Page 2 of 7

&"RI
S M Full-ronm n An¢lyt do sEnvironmental Soluans,,pnaiPR�CR u+c
Lane Construction Corporation, The
Attn: Marcus Hackler
8205 Wilkinson Blvd.
Charlotte, NC 28214
Project: Wilkinson Blvd, Shop
Sample Matrix: Water
Laboratory Report
05/30/2014
Client Sample ID: Outfall #1
Prism Sample ID: 4050398-01
Prism Work Order: 4050398
Time Collected: 05/15/14 07:55
Time Submitted: 05/15/14 10:40
Parameter Result
Units Report
MDL Dilution
Method Analysis Analyst
Batch
Limit
Factor
Daterrime
ID
General Chemistry Parameters
Oil & Grease (SGT-HEM) BRLOG
mg/L 5.0
1.2 1
'1664A 5/29114 8:50 JAB
P4E0612
Total Suspended Solids BRL
mg1L 5.0
1.0 1
'SM 2540 D 5/21/14 16:10 JAB
P4E0435
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Spring brook Road - P.D. Box 240643 - Chariotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001529.6364 - Fax: [phone] Page 3 Df 7

u n Full -Service Analytical S
L: �R I M @nvironmertal Solutions
Lane Construction Corporation, The
Attn: Marcus Hackler
8205 Wilkinson Blvd.
Charlotte, NC 28214
Project: Wilkinson Blvd. Shop
Sample Matrix: Water
Laboratory Report
05/3012014
Client Sample ID: Outfall #2
Prism Sample ID: 4050398-02
Prism Work Order: 4050398
Time Collected: 0505114 08:08
Time Submitted: 05/15/14 10:40
Parameter Result
Units Report
MDL Dilution
Method Analysis Analyst
Batch
Limit
Factor
Daterrime
ID
General Chemistry Parameters
Oil & Grease (SGT-HEM) BRLOG
mg/L 5.0
1.2 1
1664A 5t29114 8:50 JAB
P4EQ612
Total Suspended Solids BRL
mg/L 5.0
1.0 1
'SM 2540 D 5121114 16:10 JAB
P4E0435
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Spring brook Road - P.O. Box 240643 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/629.6364 - Fax: [phone] Page 4 of 7

nu-' I S M Fullor o men al SGI icol s
L Environmental Solutions
�l LAo LA— we
Lane Construction Corporation, The
Attn: Marcus Hackler
8205 Wilkinson Blvd.
Charlotte, NC 28214
Project: Wilkinson Blvd. Shop
Sample Matrix: Water
Laboratory Report
05/30/2014
Client Sample ID: Outfall #3
Prism Sample ID: 4050398-03
Prism Work Order: 4050398
Time Collected: 05/15/14 08:13
Time Submitted: 05l15/14 10:40
Parameter Result
Units Report
MDL Dilution Method Analysis Analyst
Balch
Limit
Factor Datefrime
ID
General Chemistry Parameters
Oil & Grease (SGT-HEM) BRLOG
mg1L 5.0
1.2 1 1664A 5/29114 8:50 JAB
P4E0612
Total Suspended Solids 80
mg1L 25
1.0 1 'SM 2640 D 5/21114 16:10 JAB
P4E0435
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 29224-OW
Phone: [phone] - Toll Free Number: 1-800152M364 - Fax: [phone] Page 5 of 7'

Full Se"Ice Analytical &
r� 1 V' Environmental SoluSions
®P"i.aow.,oRiEa —
Lane Construction Corporation, The
Attn: Marcus Hackler
8205 Wilkinson Blvd.
Charlotte, NC 28214
Project: Wilkinson Blvd. Shop
Sample Matrix: Water
Laboratory Report
05/30/2014
Client Sample ID: Outfall #4
Prism Sample ID: 4050398-04
Prism Work Order: 4050398
Time Collected: 05/15/14 08:18
Time Submitted: 05/15/14 10:40
Parameter Result
Units Report
MDL Dilution Method Analysis Analyst
Batch
Limit
Factor Daterrime
ID
General Chemistry Parameters
Oil & Grease (SGT-HEM) BRLOG
mg1L 5.0
1.2 1 '1664A 5129114 10:00 JAB
P4E0612
Total Suspended Solids 22
mglL 12
1.0 1 'SM 26" D 6121114 16:10 JAB
P4E0435
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 6 of 7

_...y �..-..1..._.�++�...++-+ii+�r-�r_i....-s -r--+ ..�...�.s..-! ....-. ��.-.�.�.... �..�...... -- ... ...-�.<a_. •a. •. �. r-. .... �..��. ..�. s.. l.__. �r. �_.. ... _. __.. �............................. t....-............... ....a... ....... ......
... __...,.......... _. � - `r✓
S M CHAIN OF CUSTODY RECORD
;., Full -Service Analytical &
Environmental Solutions PAGE- OF _ QUOTE o To ENSURE PROPER BILUNO:
LPBORATORIES IW_
449 Springbrook Road • Charlotte, NC 28217
Phone [phone] Fax: 704/52"409
Client Company Name: li'AJ64COC16,0 ,1
Report TolContact Name.
Reporting Address: _V, 12�5 W;lk;,.,,Sett/ B
* 4- a _Q►
Project Name:
Short Hold Analysis: (Yes) (No) UST Project: (Yes) (NO)
*Please ATTACH any project specific reporting (QC LEVEL 1 11 111 IV)
provisions and/or QC Requirements
Involce To:
Address:
•
YES'.;;:
Sampies,INTACT upon arnvah
NO NIA
Received ON WET,ICE7z .;' � i
'PROPER PRESERVATlVES.indlcasad? r
N
;.'Received WITHIN ',HOLDING'_tiMES?''
•'CUSTODYrSEALS INTACT?IL
' ' `}
_,..VOLATILES rac'd'WIOUT.HEADSPACE7.
SiPROPER:GONTAlNERSused7
��;'
;•TEMP-,: Therm 10'� "• 1 7 ,. Observed'. �. 1., C /Corr:
PhoneIM -39H- ff::ibSf Fax (0i)
purchase Order No./Bllling Reference
TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL
Email Address:
Requested Due Date ❑ 1 Day ❑ 2 Days ❑ 3 Days ❑ 4 Days ❑ 5 Days
Certification: NELAC 'DoD
FL NC
E©D Type: PDF_Excel _Other
"Working Days" ❑ 6-9 Days �tandard 10 days Ru sh Work Must Be
Pre -Approved
Site Location Name:
�`�
W tikiAl 51�H
�_�_ Samples received after 14:00 will be processed next business day.
Sc OTHER
NIA
Site Location Physical Address.•
Tumaround time is based on business days, excluding weekends and holidays.
Water Chlorinated: YES_ NO
(SEE REVERSE FOR TERMS 5 CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES. INC. TO CLIENT}
Sample Iced Upon Collection: YES
NO_
TIME
MATRIX
SAMPLE CONTAINER
i
ANALYSIS REQUESTED
PRISM
CLIENT
DATE
COLLECTED
(SOIL,
PRESERVA-
i
REMARKS
LAB
SAMPLE DESCRIPTION
COLLECTED
MILITARY
WATER OR
*TYPE TIVES
NO. i SIZE
/
ID NO.
HOURS
SLUDGE)
SEE BELOW
xa
W
n
A�
bv�-W l �.
: 08
S W
ya
00-v"I 43
9213
SLJ'PtArrA
j
S
,a
/JW
-J6 -,9w
�'!
5
X
N
v
_
I
i
I
Sampler's Signature
Sampled By (Print Name) Affiliation
Upon relinquishing, this
Chain of Custody is your authorization
for Prism to proceed with the analyses as requested above. Any changes must be
submitted In writing to the
Prism Project Manager.
There will be charges for any changes after analyses have been initialized.
Rela,qulshad By: iftnature
Recerved By: (Signeturo) Date
M nfarylliours Additional Comments:
Sue Arrival Time::....:
Relinquished By: (Signature)
Received By: (Signature) Date
ANC )mil'! , m v
Site Departure Tlnie:.
Relinquished By: (Signature)
=sm La By: Date i
,� � , ��
r J
Field Tech Fee: -
e. ..
Mileage:
Method of Shipment: NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED SHUT CUSTODY SEALS FOR TRANSPORTATION TO THE LABORATORY, COC Group No.
SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINSrpft UNTIL RECEIVED AT THE LABORATORY.
i
q �y
r3 Fed Ex Ll UPS ❑ Hand -delivered ❑ Prism Field Service
O Other
LIST
TER.
SOLID
DRINKING WATER: OWASTE: C DFC❑C❑SC
NI SC
EIC El NG ❑ SC
El I
UNC❑ I ❑SC❑ ❑El NC ❑ ❑ NCO S❑ NC ❑ SC
'CONTAINER TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space)
ORIGINAL

Stormwater Diw%arge OutfaU (SDO)
Qualitative Monitoring Report
Permit No.: Nf9-4JQ/8J2101 aI p! or Certificate of Covorage No.:
Facility Name: la+ ice! i l l-'
County: Mfr-KION hjjg mono No. ZZi-
Inspector
Date of Inspection: ;i,, 064,201q
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Perrmttee or Designee)
1. Ou fall Description
Outfall No. I Structue (pipe, ditch, etc.)
Receiving Stream: '-tit- L- - - - —
Describe the industrial activities that occur within the out, U drainage area: Mct�H•�g,- bhp
I Color i
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
i
Describe any distinct odors that the dischargc may have (i.c., srrnells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where l is clear and l o is very
cloud):
2 3 4 S b 7 g g 10
Page I
SWLL242-020M
i j

5. Floating solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
© 2 3 4 5 5 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where i is no solids and 10 is extremely muddy:
© 2 3 4 5 5 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yeses
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: NlC d,/ S /01 D 1 a pl or Gertificatc of Coverage No.: NIGGI I l� I I I
Facility Nary= 1,a i�l i i 1c,;
County: A'1�_GCl-.auhurd Phone No. qpAf
Inspector. ` oily �1 _ — Date of of Inspection- 15
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Prrmuea or
1. OMM DmApthm
Outfakl No. A . Structure (pipe, ditch, etc.) -Ca" b,,Q6;Aj - -
Receiving Stream Xkw
Describe the industrial activities that occur within the outfall drainage area: &: L�r1,o . 5It � ?
D _ t_ A. -.A-- - - i .. - . -- t- •--- +
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as desca tors:
3. odor
Describe any distinct odors that the discharge may have (i.o., smells strongly of oil, weak chlorine odor,
etc.) t4 One,
4. Chnity
Choose the number which hest describes the clarity of the discharge where I is clear and 10 is very
cloudy:
T 2 3 4 5 . b 7 8 g 1p
Page I
SWLJ-242-MOM

5. Floating Solids
Choose the number which best describes the amount.of floating solids in the stormwater discharge where
I is no solids and .10 is the surface coveted with floating solids:
li 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no solids and 10 is extremely muddy:
® Z 3 4 5. 6 7 8 9 10
7. Foam
Is there any foam in the storTnwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes 4-90
10. Erosion at Outfali
Is there erosion at or immediately below the outfall? Yes
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action.
Page 2
SVIU-242-020705

b
Stormwater Discharge Oatfall (SDO)
QuaUt five Momboring Report
Permit No.: NIC1&/ n / 8 (D /O I a l p! or Cesare of Coverage No.:, NICQQ
Facility Nam. C'a�u5 r.» WOKAISON
ammty: bgr.UgN hh I CA phone No.
Inspector. . 1l r
Date of Inspection: 15.0 ,2414 _
By this signaum, I certify that this report is accurate and complete to the best of niy knowledge:
(Signature of Perrnittee or Desi )
L Ouffiafl Deectiption
DutfaU No. �_ struct:ure (pipe, ditch, etc.) 'b _
Receiving Stream �RLw
Describe the industrial activities that occur within the outfall drainage atea:�QGi1A1"' , �17017
2. Coior
Describe the color of the discharge using basic colors (red, brown, blue, etc.) -and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.a., smells strongly of oil, weak chlorine odor,
etc.) ► f o
4. C}mity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy:
1 2 3 [] 5 . 6 7 8 9 IO
Pap i
SWU-24MO705

i
I
5. mating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
i
t . 2 3 d 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 (IF) 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in. the storinwater discharge? Yes
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes ®o
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes i Vo
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action.
Page 2
S WU-242-020705

Ot W A*,
01 �
>
Stormwater Discharge Outfall (SDU)
Qualitative Monitoring Report
Pem-dt No.: N1/Ct`—&/Q/O/D /a/ ofpl or Certificate of Coverage No.: N/CgGI / I I 1 1 /
l;aciiity Name: inn 4`- JV—'k
County: mcay'k--lU )]u 1 1 —___Phone No. r704- 39W ' V 54
inspector. `F WW WY2 w
Date of Inspection: mam
By this signature, I ccert* that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Desmpbon
Outfall No. 4-.— Sttttctttre (pipe, ditch, etc.) +"�P
Receiving Stream: �&t+u -re-ey-
-
Describe the industrial activities that occur within the outfall draigage area: ,64 i&&n,
2. Color
Describe the color of the discharge,using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have, (i.e., smells strongly of oil, weals chlorine odor,
etc.) 1409cn .
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 3 4 (T .. 5 7 8 9 10
Page 1
SWLI-242-OM05

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids:
1 2 3 �J 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no solids and 10 is extremely muddy:
1 2 3 5 6 7 8 9 10
7, Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 4&
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action.
Page 2
S W U-242-020705

Stormwater Dilsdmrge OntfA (SDO)
QuWfttive Monitoring Report
Permit No.: LUg4W-?J.D /01
Facility Name: La+k-- C'niu5�
county: h1r�CiCluhuc—
]nspector. 3;1IT A 4 --
Date of Iespection: MAq
By this 6gnwmr, I certify that this report is accurate and complete to the best of my knowledge:
(Signatures of Permitter or Designee)
1. OntM Description
4ntfali No. I Structure (pipe, ditch, etc-)
Receiving Stream:.
Describe the industrial activities that occur within the out�.drainage area: r tw�xrco �hT
2. color
Describe the color of the discharge.using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptaom C - - ..
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy.
0 2 3 4 5 6 7 S 9 10
Page t
SWU-242-02t1705

5, Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids;
© 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no solids and 10 is extremely muddy:
(� 2 3 4, 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yeses
I
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes
10. Erosion at Outfal]
Is there erosion at or immediately below the outfall? Yes
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the pmwnce of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-2424020705

Stormwater Discharge OutCaII (SDO)
Qualitative Monitoring Report
Permit No.: wC-JA�W& 101010 0/ or C fdicwc of Coverage No.:
Facility Name:: La Wily—*NSAW
County: MoaKlig-Nhura Phone: No. _ 39 — 5`4
inspector. 11
Date of Inspection:.)," am 16, .2U.1 rJBy this signature, I certify that this rgxxt is accurate and complete to the best of my knowledge:
(Signature of Perr� or Dcsignee)
I_ Ott&D Description
Oudfall No. a Structure (pipe, ditch, etc.)
Receiving Stream: :Yaw _��r��'
Describe the industrial activities that occur within the outfaII drainage arWAA:a��S11-A
I Color
Describe the color of the discharge using basic colors (red, brown, blue,.etc.) and tint (light, medium,
dark) as descriptors
Describe any distinct odors that the discharge may have (i.c., smells strongly of oil, .weak chlorine odor,
etc.) _ nlaw--
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and I0 is very
cloudy:
(l 2 3 4 5 6 7 S 9 IO
SWU-24MM05

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating salsds:
. 2 3 4 5 6 7 8 9 10.
6. Suspended Soilds
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes
9. Deposition at Outfan
Is there deposition of material (sedimehl, etc.) at or immediately below the outfall? Yes of
10. Erosion at Outfall
is there erosion at or immediately below the outfall? Yes�J
11. Other Obview Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sh=. deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
swv-242-020705

Stormwater Discharge Onifall (SDO)
Qualitative Monitoring Report
Pe�rtrii No.: I�TICI�,1 n I S IQ1010 l pl ar Ceti�cat�e of Coverage Na: 1!UGi3!_/ 1_I 1 1 !
Facility Name: LO-e. aZ5Tt:; k2n iEii,ll-iy.IzbN_
County: mf4ipN bu Ca - Phone No. 7 .---
inspector. -7a.v),rGL --- - -- - --
Dati of hmpection: _�loE rw 15 j p ! 4
By this signanue, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittoe or Dc4 )
1. OaftU Description
Outfall No. _ Structure (pipe, ditch, etc.) J Q -- —
Receiving Strearn:
Describe the industrial activities that occur within the outfaU drainage
2. Color
Describe the color of the discharge using basic colors (red., brown, blue, etc.) and tint (light, medium, i
dark) as descriptors=
3. Odor
Describe any distinct odors that the discharge may have (i.c., smells strongly of oil, weak chlorine odor.
etc.) . 1Sohle—
4. Clarity
Choose the number which best de=bes the clarity of the discharge where i is clear and 10 is very
cloudy:
1 2 3 d 5 . 6 7 S 9 ]0
PWt
SWU-242-MOM
� r
't

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stonnwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 3 d 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 (g) 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes
9. Deposition at Outfall
Is them deposition of material (sediment, etc.) at or immediately below the outfall? Yes
1
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes (io
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note; Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action.
Page 2
S W U•242•020705

rip
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N1C4C3-Igl i lk 144 0l pl or Certificate of Coverage No.: NIC/Gl 1 1 1 1 I 1
Facility Name: _ 1-a r l� [' hiS�t'.ac� ic7j!
County: caK "r& Phone No. 1764�-,�9�
Inspector: Sall i�lQ _ -
Date of Inspection: Ma 1 O 1
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Fermittee or Designee)
1. Outfall Description
Dutfall No. _ 4 Structure (pipe, ditch, etc.) Jp-jlpe
Receiving Stream: g
Describe the industrial activities that occur within the outfall draiTge area 1M i a�ury �"rt �
I Color
Describe the color of the discharge,using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) 1409c!:»
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy.
1 2 3 4 0. 6 7 8 9 10
Page I
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 3 in S 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 3 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
8. Oil Sheen
Is there an oil sheen in the stormweer discharge? Yes t i9
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes ` )
10. Erosion at Outfall
Is there erosion at or immediately below the•outfall? Yes
11. Other Obvious Indicators of Stormwater Pollution
i
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion maybe
indicative of conditions that warrant further investigation and corrective action. '
Page 2
SWU.242-020705